Ultrasound-guided Transversus Abdominis Plane Block In The Application Of The Analgesia After Cesarean Delivery

Objective To evaluate the analgesic efficacy of ultrasound-guided transversus abdominis plane(TAP)block after cesarean delivery under spinal anesthesia.Methods Ninety patients scheduled for cesarean delivery under spinal anesthesia were randomly divided into three groups by their analgesia mode:PCIA group(group P),TAP block group(group T)and TAP block combined with PCIA group(group TP)(n=30).After cesarean delivery,TAP block were performed on both sides,20ml of 0.375%ropivacaine was injected in each side in group T and group TP,while PCIA was used in group P and group TP.The score of visual analogue scale(VAS)at rest and activity and Bruggrmann comfort scale(BCS)score were evaluated at 2?4?6?8?12?24h after operation.Measure analgesic effects by cold stimulation(75%alcohol)at 4h after operarion.We will record the consumption of sufentanil and the number of PCA within 24h after operation were recorded.The adverse reactions of TAP block and PCIA were also recorded.Results The rest and activity VAS scores at postoperative 2?4?6?8?12h time point were lower in group TP than that in group P and group T,while that in group P was lower than group T(P<0.05).At postoperative 24h time point,the rest and activity VAS scores were lower in group TP and group P than group T(P<0.05),while there was no difference in group TP and group P(P>0.05).Analgesic effects in group T and group TP were both from T10 to L1 which were measured by cold stimulation(75%alcohol),and there was no analgesic effect in group P(P>0.05).The consumption of sufentanil within 24h after operation at 2?4?6?8?12?24h after surgery were the lowest in group TP while the score in group T is significantly lower than that in group P(P<0.05).The BCS score and the number of PCA in the group TP was the highest while it was higher in group P than group T.There were no adverse reactions in group T and group TP of TAP block.Conclusion Ultrasound-guided transversus abdominis plane block for postoperative analgesia in cesarean delivery can not be able to meet the demand of the analgesia as a separate analgesia mode.However,TAPB combined with PCIA reduced the postoperative pain in patients undergoing cesarean delivery and the sufentanil dosage with no adverse.TAP block can be used safely and effectively.So it can become an important way of perioperative pain management which involves in the management of multimodal analgesia and worthes to be a choice anesthetists considering.